Introduction: What is Oesophagitis?

Oesophagitis is an inflammation of the esophagus, the tube that connects the mouth to the stomach. This condition can result in symptoms like heartburn, difficulty swallowing, chest pain, and regurgitation. Oesophagitis is caused by several factors, including acid reflux, infections, and certain medications. When left untreated, it can lead to more severe complications like ulcers, scarring, and narrowing of the esophagus.

The esophagus plays a vital role in the digestive system, transporting food and liquids from the mouth to the stomach. However, when the esophagus becomes irritated or inflamed, it can disrupt this process and cause significant discomfort. Understanding the causes, symptoms, and treatments of oesophagitis is essential for effective management of the condition.

Causes of Oesophagitis

There are several factors that can lead to oesophagitis. The most common causes include:

1. Gastroesophageal Reflux Disease (GERD)

GERD is the most frequent cause of oesophagitis. In GERD, stomach acid frequently leaks into the esophagus, causing irritation and inflammation. This backflow of acid is known as acid reflux. Over time, GERD can cause oesophagitis and lead to complications like esophageal ulcers and narrowing.

2. Infections

Certain infections, particularly fungal or viral infections, can cause oesophagitis. These infections are more common in people with weakened immune systems. Fungal infections such as Candida (yeast) or viral infections like herpes simplex can cause irritation and inflammation in the esophagus.

3. Medications

Some medications, especially those taken in pill form, can irritate the esophagus and lead to oesophagitis. Common culprits include:

• Pain relievers like aspirin or ibuprofen
• Antibiotics
• Bisphosphonates used to treat osteoporosis
• Iron supplements

These medications can cause inflammation or ulcers if they become stuck in the esophagus or if they irritate the esophageal lining.

4. Allergies and Autoimmune Disorders

In some cases, oesophagitis is linked to allergic reactions. Eosinophilic oesophagitis (EOE) is a type of allergic inflammation that can occur when white blood cells (eosinophils) accumulate in the esophagus. This condition is often triggered by allergens, such as certain foods or environmental factors.

5. Radiation Therapy

Patients undergoing radiation therapy for cancers in the chest or upper abdomen may develop oesophagitis as a side effect. Radiation can cause inflammation in the esophagus, making it painful to swallow.

6. Alcohol and Smoking

Chronic alcohol use and smoking can irritate the esophagus and increase the risk of oesophagitis. Alcohol can relax the lower esophageal sphincter, allowing stomach acid to reflux into the esophagus, while smoking damages the mucous lining, making the esophagus more vulnerable to inflammation.

Symptoms of Oesophagitis

The symptoms of oesophagitis can vary depending on the severity of the inflammation and the underlying cause. Common symptoms include:

• Heartburn: A burning sensation in the chest or throat, often after eating or when lying down.
• Difficulty swallowing (Dysphagia): A feeling of food getting stuck in the chest or throat, or pain when swallowing.
• Chest pain: A sharp or burning pain in the chest, often mistaken for heart-related pain.
• Regurgitation: The sensation of acid or food coming back up into the throat or mouth.
• Sore throat: Persistent throat irritation or soreness, which may worsen after eating or drinking.
• Nausea or vomiting: In severe cases, inflammation can cause nausea or vomiting, especially when the esophagus is irritated.

If you experience any of these symptoms, particularly persistent heartburn or difficulty swallowing, it is important to seek medical attention. Early diagnosis and treatment can help prevent complications and manage symptoms effectively.

Diagnosis of Oesophagitis

To diagnose oesophagitis, your healthcare provider will perform a physical examination and review your symptoms and medical history. Several diagnostic tests may be used, including:

• Endoscopy: A procedure where a small camera is inserted through the mouth to visually inspect the esophagus for signs of inflammation, ulcers, or other abnormalities.
• Biopsy: A tissue sample may be taken during an endoscopy to check for signs of infection, inflammation, or other conditions.
• Esophageal pH Monitoring: This test measures acid levels in the esophagus to diagnose GERD as the cause of oesophagitis.
• Barium Swallow X-ray: A special X-ray that highlights the esophagus and can reveal abnormalities like strictures or ulcers.

Your doctor will determine the most appropriate diagnostic test based on your symptoms and medical history.

Treatment of Oesophagitis

The treatment for oesophagitis depends on the underlying cause and the severity of the condition. Common treatment options include:

1. Lifestyle Modifications

For patients with GERD-related oesophagitis, lifestyle changes can be very effective in managing symptoms. Recommendations include:

• Elevating the head of the bed to prevent acid reflux at night.
• Eating smaller meals more frequently instead of large meals.
• Avoiding trigger foods such as fatty foods, chocolate, caffeine, spicy foods, and citrus.
• Quitting smoking and reducing alcohol consumption.
• Losing weight if you are overweight or obese, as excess weight can contribute to GERD.

2. Medications

Depending on the cause of the oesophagitis, various medications may be prescribed, including:

• Proton Pump Inhibitors (PPIs): These reduce stomach acid production and are commonly prescribed for GERD-related oesophagitis.
• H2 Blockers: These drugs also reduce acid production in the stomach.
• Antacids: Over-the-counter antacids may help relieve heartburn and acid reflux.
• Antifungal or Antiviral Medications: If oesophagitis is caused by an infection, antifungal or antiviral medications may be prescribed.
• Corticosteroids: These may be prescribed for eosinophilic oesophagitis, an allergic condition.

3. Surgery

In rare cases, when medications and lifestyle changes don’t provide relief, surgery may be necessary. Surgical options can include:

• Fundoplication: A procedure to tighten the lower esophageal sphincter and prevent acid reflux.
• Esophageal Dilation: A procedure to stretch the esophagus if it has become narrowed due to scarring from chronic inflammation.

Prevention of Oesophagitis

To prevent oesophagitis, it's important to manage the risk factors and adopt healthy habits. Here are some tips to reduce the likelihood of developing oesophagitis:

• Avoid triggers like spicy foods, acidic foods, and alcohol.
• Practice good eating habits by eating slowly and avoiding overeating.
• Don’t lie down immediately after eating; wait at least two to three hours before reclining.
• Quit smoking and reduce alcohol intake to minimize irritation to the esophagus.

Conclusion

Oesophagitis is a common but treatable condition that can cause significant discomfort. Whether caused by GERD, infections, medications, or allergies, it is essential to seek proper diagnosis and treatment to prevent complications like scarring, narrowing, or permanent damage to the esophagus. By making lifestyle changes, taking medications as prescribed, and following a doctor’s advice, most people with oesophagitis can manage the condition effectively and lead a normal life.

If you’re experiencing symptoms of oesophagitis or suspect you may have this condition, it’s crucial to consult with a healthcare provider. Early intervention can prevent further complications and improve your quality of life.

Consult us today at Unity gastro & liver hospital for expert guidance!